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Table 4 Mental health (MH) service use

From: Implementation of three innovative interventions in a psychiatric emergency department aimed at improving service use: a mixed-method study

  Brief intervention team
(n = 44)
Crisis center team
(n = 37)
Total
(n = 81)
Before a After b Before a After b Before a After b
n/mean %/SD. n/mean %/SD. n/mean %/SD. n/mean %/SD. n/mean %/SD. n/mean %/SD.
Has a family doctor 31/41 75.61 N/A N/A 31/34 91.18 N/A N/A 62/75 82.67 N/A N/A
Use of services 30 68.18 201 45.45* 28 75.68 261 70.27 58 71.60 461 56.79*
Primary care (n = 30)   (n = 20)   (n = 28)   (n = 26)   (n = 58)   (n = 46)  
General practitioners 20 66.67 51 25.00** 20 71.43 141 53.85 401 68.97 191 41.30**
Local community health service centers 12 40.00 91 45.00 10 35.71 71 26.92 221 37.93 161 34.78
Psychologists (private practice) 12 40.00 81 40.00 12 42.86 81 30.77 241 41.38 161 34.78
Community organizations 5 16.67 22 10.00 12 42.86 71 26.92 171 29.31 91 19.57
Specialized services
Outpatient psychiatrists 5/30 16.67 0/202 0.00 19/28 67.86 14/261 53.85 24/58 41.38 14/451 31.11
Outpatient hospital services 2 4.55 22 4.55 24 64.86 251 67.57 26 32.10 271 33.33
Number of different types of outpatient hospital services (mean, SD.) c 1.00 0.00 1.003 0.00 1.38 0.65 1.283 0.61 1.35 0.63 1.263 0.59
Frequency of overall outpatient hospital services used (mean, SD.) 1.00 0.00 2.003 0.00 6.79 7.20 4.803 3.28*** 6.35 7.09 4.593 3.24***
Duration of overall outpatient hospital services used in weeks (mean, SD.) 14.64 14.45 5.143 1.62 31.70 16.30 15.673 7.59 30.38 16.56 14.893 7.82
Emergency department (ED) visits 14 31.82 61 16.22* 20 45.45 141 37.84 34 41.98 201 24.69*
Number of ED visits (mean, SD.) d 1.43 0.85 1.833 0.75 2.20 1.58 1.793 0.89 1.88 1.37 1.803 0.83
Hospitalization 5 11.36 42 10.81 23 52.27 111 29.73** 28 34.57 151 18.52*
Number of hospitalizations (mean, SD.) 1.20 0.45 1.253 0.50 1.61 0.89 1.093 0.30 1.54 0.84 1.133 0.35
Adequacy of MH services (mean SD.) e 2.05 0.82 2.703 0.47** 2.42 0.73 2.623 0.64 2.22 0.80 2.653 0.57**
Reasons why needs were not met (Denominator: n) (n = 28)     (n = 16)     (n = 44)    
Preferred to manage on his/her own 2 7.14 N/A N/A 6 37.50 N/A N/A 8 18.18 N/A N/A
Reasons related to healthcare system f 24 85.71 N/A N/A 15 93.75 N/A N/A 39 88.64 N/A N/A
Reasons related to the person (individual reasons) g 14 50 N/A N/A 12 75 N/A N/A 26 59.09 N/A N/A
  1. aMeasured at 12 months before ED visit with referral to an intervention
  2. bMeasured at 6 months after discharge from the intervention
  3. cTypes of outpatient services used including brief evaluation and intervention programs, outpatient clinics (specialized MD), day hospitals, and other types of specialized outpatient MH services (e.g. electrophysiology, nutrition)
  4. dThis account of the 12-month ED visits did not include the ED visit leading to the interventions
  5. eMeasured on a five-point Likert scale (1: the services are not adequate to 5: the services are entirely adequate)
  6. fHealthcare system reasons included: help isn’t readily available, language problems, don’t have the financial means, insurance doesn’t cover the costs, don’t have confidence in the services, dissatisfied with the quality of services
  7. gIndividual reasons included: don’t know how or where to obtain the type of help appropriate to my problem, don’t find time to look after it, employment or occupation prevented me from seeking help, afraid of what others will think of me, prefer to count on my family or friends to help me
  8. 1,2,3Comparison analyses were conducted to assess statistical differences between groups (before and after) by teams (brief intervention team, crisis center team and total): 1 Chi-square test or 2 Fisher’s exact test were used for categorical variables and 3 t-tests for continuous variables. Significance indicated by: p < 0.001***; p < 0.01**; p < 0.05*